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EP4183351A2 - Appareil pour chirurgie mini-invasive de l'oignon - Google Patents

Appareil pour chirurgie mini-invasive de l'oignon Download PDF

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Publication number
EP4183351A2
EP4183351A2 EP22198088.1A EP22198088A EP4183351A2 EP 4183351 A2 EP4183351 A2 EP 4183351A2 EP 22198088 A EP22198088 A EP 22198088A EP 4183351 A2 EP4183351 A2 EP 4183351A2
Authority
EP
European Patent Office
Prior art keywords
jig
track
metatarsal
contact pad
arm
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
EP22198088.1A
Other languages
German (de)
English (en)
Other versions
EP4183351A3 (fr
Inventor
Joseph Ryan WOODARD
Johnny MCGEE
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Wright Medical Technology Inc
Original Assignee
Wright Medical Technology Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Wright Medical Technology Inc filed Critical Wright Medical Technology Inc
Publication of EP4183351A2 publication Critical patent/EP4183351A2/fr
Publication of EP4183351A3 publication Critical patent/EP4183351A3/fr
Pending legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
    • A61B17/1775—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the foot or ankle
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8866—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices for gripping or pushing bones, e.g. approximators
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8897—Guide wires or guide pins
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/60—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements for external osteosynthesis, e.g. distractors, contractors
    • A61B17/66—Alignment, compression or distraction mechanisms
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/846—Nails or pins, i.e. anchors without movable parts, holding by friction only, with or without structured surface
    • A61B17/848—Kirschner wires, i.e. thin, long nails
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B2017/564—Methods for bone or joint treatment
    • A61B2017/565—Methods for bone or joint treatment for surgical correction of axial deviation, e.g. hallux valgus or genu valgus

Definitions

  • the disclosed subject matter relates generally a guide system and method to aid an orthopedic surgeon in translating the distal bone fragment and inserting a k-wire into the bone.
  • Minimally invasive bunion surgery also known as percutaneous bunionectomy, is a surgical procedure that seeks to correct a bunion deformity by utilizing a small incision.
  • Hallux Valgus is a deformity of the big toe joint wherein a deviation of the big toe towards the lesser toes results in a prominent bump, or bunion.
  • k-wires Kirschner wire
  • Prior art methods require one instrument to be used for translation of the distal bone fragment and another to be used for k-wire targeting. Maintaining adequate translation while applying and using the targeting guide can be cumbersome and represents a challenge to the surgeon.
  • surgeons utilize K-wires to both stabilize the position of bones and to serve as guide wires for screw insertion. It is not uncommon for surgeons to require multiple k-wire insertions before they place the guide wire into the desired position. However, repeated k-wire insertions require time, increase frustration during the procedure, and represent micro-injuries to the bone that the body must heal in addition to the surgical correction.
  • the embodiments described herein are directed to a system, apparatus, and method for bunion correction utilizing a guide for translating the metatarsal head with respect to the metatarsal shaft subsequent an osteotomy and guiding a k-wire utilized in the fixation of the head and shaft in the relative translated position.
  • a guide for translating the metatarsal head with respect to the metatarsal shaft subsequent an osteotomy and guiding a k-wire utilized in the fixation of the head and shaft in the relative translated position.
  • a system for performing a percutaneous bunionectomy including a jig having a body, a shaft contact pad connected to the jig body and conformed to the soft tissue proximate the metatarsal shaft, an arm extending in a longitudinal direction from the jig body, a metatarsal head contact pad connected to the arm and configured to conform to the soft tissue proximate the metatarsal head; a track rigidly connected to the second arm end and movably connected to the jig body and a circular track cooperating with an engagement mechanism of the track, such that a rotation of the track drive results in a lateral movement of the track.
  • the system further includes an alignment guide arm connected to and extending longitudinally from the jig body and a plurality of positioning k-wires, attaching each of the metatarsal head contact pad and the metatarsal shaft contact pad through a multi-dimensional fixation hole to the metatarsal bone.
  • a guide wire is also provided in the system for insertion through the displaced shaft and head of the metatarsal to assist in the subsequent insertion of a fixation screw.
  • a method including the steps of creating an incision in the soft tissue of the foot, positioning a jig upon the soft tissue surrounding the metatarsal bone; securing the jig to the metatarsal bone and, via the incision cutting the metatarsal bone, creating a first portion of the metatarsal and a second portion of the metatarsal.
  • the method further includes translating the jig track to laterally displace the second portion with respect to the first portion; adjusting the visual alignment guide to a desired trajectory; and inserting a fixation k- wire as a screw guide through the first and second portions of the metatarsal such that a fixation screw may permanently fix the bone portions in the laterally displaced position.
  • the jig is subsequently removed from the metatarsal and the incision is closed.
  • a translation and insertion jig for insertion of a k-wire having a body, a shaft contact pad connected to the jig body and conformed to the soft tissue proximate metatarsal shaft, an arm extending in a longitudinal direction from the jig body, a metatarsal head contact pad connected to the arm and configured to conform to the soft tissue proximate the metatarsal head; a track rigidly connected to the second arm end and movably connected to the jig body and a track drive cooperating with an engagement mechanism of the track, such that a rotation of the track drive results in a lateral movement of the track.
  • the system further includes a lock configured to selectively restrain the track from translation relative to the jig body and an alignment guide arm connected to and extending longitudinally from the jig body.
  • a system and method for performing a percutaneous bunionectomy wherein the system includes a jig, which subsequent to attachment and performance of an osteotomy on the bone, uses a rack and pinion mechanism to translate the separated portion of the bone to a surgeon determined displacement ⁇ , wherein a locking mechanism maintains the desired displacement of the bone portions and allows the surgeon, with use of an attached visual guide, to insert a k-wire through the bone portions to serve as a guide wire for the internal fixation that maintains the displacement during the healing, and wherein the system removes the requirement that the surgeon manually maintain the desired displacement while inserting the guide wire.
  • Couple should be broadly understood to refer to connecting devices or components together either mechanically, or otherwise, such that the connection allows the pertinent devices or components to operate with each other as intended by virtue of that relationship.
  • Fig. 1 illustrates a translation and insertion jig 100 for minimally invasive bunion surgery.
  • the jig includes a body 110 which extends from its first end 112 configured to face the bone to a second end 114.
  • the jig 100 includes a metatarsal shaft contact pad 122 connected to the first end 112 of the jig body 110.
  • the shaft contact pad 122 is preferably conformed to the portion of soft tissue (e.g., skin, muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body) covering the foot proximate to the metatarsal shaft to which it is intended to engage (e.g. concave).
  • the contour of the shaft contact pad 122 may be conformed during surgery to match the soft tissue surrounding the bone, or pre-contoured.
  • the shaft contact pad 122 may also be selectable by the surgeon from a plurality of different sizes and shapes, such that the jig 100 may have a set of interchangeable contact pads, or pads that attach to the first end 112.
  • the shaft contact pad 122 along with the head contact pad 124 discussed later, include at least one k-wire insertion hole 126, 128 that allows multi-dimensional fixation (i.e., restraint of relative movement in the vertical, lateral and longitudinal directions) of the pads 122, 124 to the respective shaft and head of the metatarsal bone (as shown in Fig. 3 ).
  • a linear track 140 extending in the lateral direction, the track 140 rigidly connected to the second end 134 of the extending arm 130 and movably connected to the jig body 110.
  • the linear track 140 includes an engagement mechanism, which, shown in Figs 1-7 , is the rack of a rack and pinion mechanism which includes a toothed surface 142.
  • the track 140 alternatively may have a threaded surface such as in a lead screw mechanism.
  • the track 140 is retained to the jig body to allow only lateral movement.
  • Fig. 4 illustrates a groove 117 in the jig body 110 that retains the track 140 in one embodiment, of course other known retention methods are also envisioned.
  • the track 140 may be incremented to enable the surgeon to ascertain the amount of lateral translation and may be further indexed to move one increment (click) at a time, via indentations and ball stops (not shown), or other indexing mechanism known in the art.
  • the jig 100 has a longitudinal extending arm 130, a second end 134 of the arm 130 attached to a track 140.
  • the extending arm 130 may be contourable, pre-contoured, or modular such that different sizes and shapes may be selected by the surgeon to be attached directly or indirectly to the track 140.
  • On the other end 132 of the extending arm 130 is a second contact pad 124 for the engagement of the soft tissue surrounding the metatarsal head proximate the pad 124.
  • the contour of the head contact pad 124 may also be conformed during surgery to a shape that matches the soft tissue proximate the bone (e.g. concave) or pre-contoured.
  • the head contact pad 124 may also be selectable by the surgeon from a plurality of different sizes and shapes, such that the jig 100 may have a set of interchangeable contact pads, or pads inserts that attach to the first end 132 of the arm 130.
  • the arm 130 may include a longitudinal section 131, a lateral section 133 and a vertical section 135 to position the head contact pad 124.
  • the longitudinal section 131 and the vertical section 135 may be adjustable by the surgeon to adjust the position of the head contact pad 124, or alternatively may be selectable from a plurality of sizes and shapes in the same manner discussed above.
  • a track drive 150 (see also, Figs. 4 , 7 ), including a manual knob 155, dial, or wheel is rotatably connected to the jig body 110, at least a portion of the knob or dial wheel extending outside the jig body 110 to be accessible for manual engagement.
  • the track drive cooperating with the engagement mechanism of the track 140.
  • the track drive 150 includes a circular gear with intermeshing teeth 157 that functions as a pinion in a rack and pinion mechanism, the rack and pinion may also engage frictionally with high friction surfaces on the pinion 150 and cooperating track 140.
  • the track drive may be a worm drive, an internally threaded wheel of a lead screw mechanism, or a ball thread drive, each of which translates rotation of the knob, dial or wheel into linear lateral advancement of the track 140 (i.e., rotation of the track drive moves the track 140 and arm 130 laterally.
  • Each increment of rotation of the circular drive (pinion) or length of track (rack) may be biased into position with known methods such as stop points achieved using teeth or ball plungers so that the track clicks into a plurality of positions laterally spaced from the jig body.
  • each increment may be of a predetermined measurement such as a mm or fraction thereof.
  • a track lock 160 is attached to the jig body 110 configured to selectively restrain the track from translation relative to the jig body 110.
  • the track lock 160 when engaged prevents the track 140 from retracting laterally and in some embodiments prevents any lateral translation irrespective of direction.
  • the track lock 160 may take the form of a ratchet, allowing the track to advance but not retract, an interlock 162 (as shown in Fig. 7 ) in which the lock 160 does not allow any translation.
  • the track lock 160 is preferably biased in a locking position, freeing the surgeon from holding the jig to maintain the bone displacement.
  • the track lock 160 may directly engage the track 140 to prevent its translation, or may engage the track drive 150 preventing it from rotating and thus restrict translating.
  • the track lock 160 may alternatively be a threaded restraint screw (not shown) tightened to frictionally engage either the track 140 or drive 150, and loosened to release the same, or vice versa.
  • the track lock 160 shown in Figs. 3 and 6 , is biased in the locked position by a spring 163 and released by pressing button 164 removing the interlock 162 from the pinion gears 157, as shown in Fig. 7 .
  • the track drive 150 is a lead screw or worm drive
  • the mechanical configuration largely limits the need for a track lock 160 since the track 140 cannot drive the track drive 150, thus locking the track 140 in place.
  • An alignment/targeting guide arm 170 is removably attached to the jig body 110 and extends longitudinally from the jig body 110.
  • a post 172 extends vertically from an end of the alignment guide arm, and visual alignment rod 174 is attached to the post which is selectively rotatable about a vertical axis with respect to the alignment guide arm 170 for establishing the desired trajectory in the A-P plane.
  • a second visual alignment rod which is selectively rotatable about a horizontal axis with respect to the alignment guide arm may also be beneficial in establishing the desired trajectory in the lateral plane.
  • the post 172 may feature one or more holes 176a,b aligned with the alignment rod 174.
  • holes 176a,b may be beneficially sized to accept 3.0 mm and/or 4.0 mm MICA Screw k-wires, for insertion into the metatarsal portions using the jig 100.
  • the visual alignment rod 174 may be created via hole in the vertical post 172 through which a k-wire is inserted to serve as the visual alignment rod 174 when fluoroscopy is used.
  • the alignment guide 170 may also incorporate sleeves through which k-wires are inserted to ensure the wires enter the bone at the proper trajectory.
  • Fig. 2 illustrates the jig 100 positioned on the soft tissue (not shown) proximate the metatarsal 210 of a foot 201.
  • the shaft contact pad 122 is positioned upon the soft tissue covering the metatarsal shaft 211 and the head contact pad 124 is positioned upon the soft tissue covering the metatarsal head 212.
  • the track 140 and arm 130 are in the retracted or initial position.
  • the extending arm 130 may be configured with respect to the anticipated incision location so as not to interfere with the osteotomy instruments access to the metatarsal bone 210 via the incision.
  • the shape of the extending arm 130 leaves an access area 280 to the metatarsal 210 between 270 and 360 degrees.
  • Fig. 3 illustrates the attachment of the jig 100 to the metatarsal bone 210 via k-wires 324 and 322.
  • the respective k-wires 322 and 324 are inserted through holes 126 and 128 in contact pads 124 and 122 respectively through the soft tissue and into the shaft 211 and head 212 of the metatarsal 210.
  • the holes 126 and 128 are preferably oriented to direct the k-wires into the bone to ensure multi-dimensional fixation of each of the contact pads 122 and 124 to the shaft 211 and head 212 of the metatarsal bone 210.
  • the multi-dimensional fixation of each portion of the metatarsal bone 210 is desirable to ensure the jig 100 remains secured to the respective bone portions subsequent the osteotomy.
  • the jig 100 positioned on the metatarsal bone 210 is shown subsequent to the osteotomy 410.
  • the metatarsal 210 is divided into a shaft portion 412, including the shaft 211, being attached to the shaft contact pad 122 and a head portion 414 including the head 212 being attached to the head contact pad 124.
  • the track 140 and extending arm 130 are shown in a retracted position or initial position prior to the translation of the head portion 414 with respect to the shaft portion 412 via the jig 100.
  • Fig. 5 illustrates the jig 100 with the track 140, arm 130 and the head contact pad 124 extended to the desired location selected by the surgeon.
  • the head portion 414 has been translated laterally from the shaft portion 412 by ⁇ .
  • the track 140 is configured to laterally translate from a first position as shown in Figs. 2 , 3 and 4 to a fully translated position including any intermediate surgeon selectable position as shown in Fig. 5 and 6B .
  • the track 140 is restrained to a predetermined path, typically a straight line, however, it may be beneficial in some circumstances for the path to be curved or not linear.
  • Figs. 6A and 6B the insertion of the guide wire 601 through the shaft portion 412 and head portion 414 of the metatarsal 210 is shown.
  • the k-wire 601 With the translation ⁇ established and maintained via the jig 100, the k-wire 601 is placed through the k-wire hole (176a,b) in the post 172 and inserted into the metatarsal 210 following the trajectory established by visual guide rod 174.
  • a screw may then be guided by the guide wire 601 into the shaft portion 412 and head portion 414 of the metatarsal to fix the translation ⁇ throughout the healing period. Because of the lock 160 or the inherent nature of the track drive 150, the displacement ⁇ is maintained by the jig 100 without the necessity of surgeon's attention or hands, which are freed for the insertion of the guide wire 601 and ultimately the fixation screw (not shown).
  • FIG. 6B illustrates an anterior posterior (A-P) view, i.e. looking down upon the foot 201.
  • the visual guide rod 174 is coincident with the surgical k-wire 601 when the k-wire 601 is following the prescribed trajectory in the A-P view as shown in Fig. 6B . If a second visual guide is provided, it would be coincident with the surgical k-wire 601 when the k-wire 601 is following the prescribed trajectory in the lateral view, generally shown in Fig. 6A .
  • the location and movement of the inserted k-wire 601 in the A-P view may be represented by the visual guide rod 174, additionally, the visual guide rod 174 may also be rotatable with respect to the horizon and thus act as an insertion guide in the lateral plane (i.e. the plane normal to the lateral direction), though it requires the surgeon to account for the vertical offset in the lateral view.
  • the second guide rod (not shown) may govern movement of the inserted k-wire 601 in the lateral plane.
  • the location and trajectory of the inserted k-wire 601 may be represented in three dimensions and thus monitored and controlled using one or two visual guide rods.
  • Fig. 8 illustrates a method 800 for performing a percutaneous bunionectomy using the jig 100.
  • an incision in the soft tissue of the foot 201 of a patient is created by the surgeon as shown in Block 802.
  • the jig 100 is positioned upon the soft tissue (not shown) proximate the metatarsal bone 210 of the foot 201 as shown in Block 804 (see also Fig 2 which illustrates the jig 100 on the soft tissue proximate the metatarsal 210).
  • the shaft contact pad 122 and a head contact pad 124 of the jig 100 are proximate the shaft 211 and head 212 respectively of the metatarsal bone 210.
  • the jig 100 is secured to the metatarsal bone 210 as illustrated in Fig. 3 .
  • the jig 100 is secured to the bone via k-wires 322 and 324 inserted through the contact pads, soft tissue and into the bone, however it is envisioned other fastening devices (i.e. screws, pins, clamps etc.) may also have beneficial applications.
  • Block 808 the metatarsal bone is accessed through the incision and is cut creating first and second portions 412 and 414 of the metatarsal 210, the result of the osteotomy 410 is illustrated in Fig. 4 .
  • the jig track 140 is then translated by manually rotating knob 155 of the track drive 150 such that the desired displacement ⁇ is achieved between the two portions as shown in Block 810.
  • Fig. 5 illustrate the track 140, arm 130, head contact pad 124 and head portion 414 of the metatarsal with the desired displacement ⁇ .
  • the locking mechanism 160 or the mechanical configuration of the track drive 150 prevents the track 140 from retracting, thus in some embodiments, the locking mechanism must be activated subsequent translation, or in the case where the locking mechanism 160 is biased in a locking position, the locking mechanism would be released to allow the translation of the track 140.
  • the visual guide rod 174 of the alignment guide 170 is adjusted to the desired trajectory.
  • Fig. 6B illustrates the visual guide rod 174 aligned along the surgeon selected trajectory.
  • a guide wire is inserted through the first and second portions 412 and 414 of the metatarsal 210 to fix the first and second portions in the laterally displaced position.
  • Fig. 6A illustrates the k-wire 601 inserted through the shaft portion 412 and the head portion 414 when they are displaced by ⁇ . The surgical k-wire 601 is positioned through one of the guide holes 176a, 176b and into the soft tissue of the foot 201.
  • the k-wire 601 is advanced while aligning it with the visual guide rod 174 in the A-P plane, and if a second guide rod is provided, then aligning the k-wire 601 with the other guide rod in the lateral plane.
  • the surgeon may check the position in both A-P and lateral planes to determine trajectory of surgical k-wire and adjust as needed. These latter steps typically require use of fluoroscopy to confirm intended trajectory has been achieved.
  • the surgical k-wire 601 is advanced into the bone while maintaining the desired trajectory in the lateral and A-P planes with reference to the respective visual guides.
  • the surgical k-wire may be advanced incrementally and its position and orientation again verified via the visual guide as it is advanced.
  • a fluoroscope is preferably used to visualize the bone and the surgical k-wire with reference to the visual guide.
  • the visual guide rod 174 is not X-ray permeable, so it will appear on the fluoroscope.
  • the jig 100 is removed from the metatarsal 210. Subsequent removal of the jig 100, the surgeon may use a depth gage placed over the guide k-wire 601 to measure screw length. The surgeon then places a drill over the k-wire 601 with a cannulated drill, then inserts a fixation screw over the k-wire to properly fixate the osteotomy. The guide wire 601 is then removed. A second screw may also be placed lateral to this screw depending on patient anatomy and needs. The incision is closed in Block 818.
  • the visual guide 170 may have one or more guide rods that extend parallel to the surgical k-wire and serve as representations of the surgical k-wire within the respective planes, to assist in its proper insertion.
  • the visual guides may be any narrow elongated straight rod, strip or bar that achieve the desired goal of visually referencing the position of the surgical k-wire being inserted.
  • Examples may be rods formed from plastic, ceramic, metal or organic material, or composites thereof.
  • materials that are x-ray permeable, non-permeable material may be added to enable the guide to be visible under a fluoroscope.
  • jig 100 shown in Figs 1-7 is configured for the left foot, it is equally envisioned that the jig could be likewise configured for the right foot, or even configured for universal use on both the left and right feet with minor adjustments as understood by one skilled in the art.
  • the disclosed subject matter is described with respect to a rack and pinion system (i.e. the track is the rack and the drive is the pinion) other configurations are also envisioned, such as a worm drive for translating the track, ball-screw drive system, or a lead screw system.
  • the lock is described with respect an interlock key, other configurations, such as a frictional lock or ratcheting lock are also envisioned.
  • the method shown in Fig. 8 describes the positioning and securing of the jig 100 prior to the creation of the incision, and/or the osteotomy.
  • one or both of the incision and the osteotomy may be performed prior to the positioning and/or securing of the jig 100.
  • the jig 100 need not account for access 280 to the bone 210, other than for the guide wire 601 and subsequent fixation screw.
  • jig 100 is described in view of minimally invasive bunion surgery, it may also be useful in other osteotomies in which portions of a bisected bone are displaced relative to one another, as may be appreciated by those skilled in the art.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
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  • Oral & Maxillofacial Surgery (AREA)
  • Dentistry (AREA)
  • Surgical Instruments (AREA)
EP22198088.1A 2021-11-18 2022-09-27 Appareil pour chirurgie mini-invasive de l'oignon Pending EP4183351A3 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US202163264246P 2021-11-18 2021-11-18
US17/933,640 US20230149031A1 (en) 2021-11-18 2022-09-20 Methods and apparatus for minimally invasive bunion surgery

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EP4183351A2 true EP4183351A2 (fr) 2023-05-24
EP4183351A3 EP4183351A3 (fr) 2023-08-02

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USD1068078S1 (en) 2023-02-08 2025-03-25 Treace Medical Concepts, Inc. Handle for an orthopedic instrument
CN118319456B (zh) * 2024-05-06 2024-11-19 航天中心医院 一种微创拇外翻三维定向定量矫正导向装置

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